Histological healing induced by tofacitinib in ulcerative colitis: A multicentre study

Area of Science:

• Gastroenterology
• Pharmacology
• Immunology

Background:

• Tofacitinib is effective for ulcerative colitis (UC) clinical and endoscopic remission.
• Its efficacy in inducing histological remission in UC remains largely unexamined.

Purpose of the Study:

• To evaluate the effectiveness of tofacitinib in achieving histological remission in UC patients.
• To assess factors influencing treatment outcomes and durability.

Main Methods:

• Retrospective multicentric cohort study of UC patients (≥16 years) treated with tofacitinib.
• Histological activity assessed using the Nancy index and epithelial neutrophilic infiltrate before and after induction.
• Primary endpoint: histological remission at the end of induction.

Main Results:

• 42 UC patients included, most with prior anti-TNF and vedolizumab exposure.
• 19% and 24% achieved histological remission based on Nancy index and epithelial neutrophilic infiltrate, respectively.
• Absence of epithelial neutrophilic infiltrate correlated with significantly longer tofacitinib treatment survival (p=0.036).

Conclusions:

• Tofacitinib induces histological remission in 19-24% of heavily pre-treated UC patients.
• Histological remission may predict longer treatment durability.
• Further research is warranted to optimize tofacitinib use for histological healing in UC.